Induction by breaking waters H

[roary]

I am nearly 41 wks with my 2nd. I was induced at 42 weeks with my first and the experience was not ideal. Apparently in Oxford if you are induced after your first baby it is done by breaking the waters (amniotomy) rather than a gel first. Nice guidelines fairly emphatically state that this should not be done except where they worry about uterine hyperstimulation. Are there any good reasons to induce by breaking waters? What are the dangers? At this stage i plan to insist on a gel unless there's sound thinking behind oxfords decision to ignore nice!

Sorry, don't know the answer but am also interested as I am also 41 weeks and booked in for induction on Saturday.

The 3 inducton methods according to the leaflet are pessary, breaking of waters, syntocin drip, in that order.

The leaflet I've been given appears to suggest the pessary is used to open/soften the cervix, but at my sweep I was found to be 2cm dilated already, so was wondering whether they would skip the pessary and go straight to breaking my waters, so I'd be intesrested in any potential issues with this approach.

Hopefully, it's all academic anyway, and I'll go into labour very soon all on my own!! (Losing faith on this though)

Toffee, hope that this is all academic as you are giving birth somewhere! I couldn't sleep the other night and did a bunch of research answering my own question.

The reason, it appears, why NICE recommends a gel first is that this is nearly often enough to kickstart labour on its own, and when it does so, women are less likely to need oxytocin drips and further interventions then with other methods. It appears that women who go in to labour with just the gel have less painful labours. There is also a higher risk of infection with breaking the waters.

I had also thought that it might be faster to just skip the gel and go straight to waters broken but no longer sure that's the case. I also had a bad postpartum infection with my first (quite a long time between waters broken and birth) and so will insist on at least one gel before having my waters broken.

There is no clinical reason to induce labour just because you are 41 weeks pg so you are totally within your right to say no, I would rather wait and see.

A normal full term pregnancy is anywhere from 38 - 42 weeks. In France, they use 42 weeks instead of 40 weeks for a term baby.

If they are worried about the placenta, amiontic fluid, etc, you can request expectant management. search the term on Mumsnet and lots of info will come up.

Don't worry, Foxytocin, am not going to be induced till 42 weeks. Just planning ahead as I am fairly certain I will be induced (or at least planning that way makes me feel better!)

I couldn't imagine waiting longer than that, TBH. I hate being pregnant. And DD took 3 days post induction to come out so I have a nasty feeling I just have long pregnancies.

Hopefully with planning I will surprise myself and go into spontaneous labour!

Anyone have any further info about breaking waters as a method of inductioN?

I was induced with my first baby and they started by breaking my waters, it didn't help so 4 hours later they put me on a syntocin drip and started pumping antibiotics in at the same time to reduce the risk of infection - 14 hours later DD was helped out with forceps.
The water breaking didn't hurt too much or anything, but it certainly didn't speed anything up.

Hi Roary, no unfortunately I'm still here waiting and like you am now of the mindset that I will be induced (although I have another 4 days for something to happen on its own, and really hope it does).

Thanks for the info on amniotomy - I had thought this would start things off fairly instantly and obviously this isn't always the case - so if it comes to it I too will discuss starting off with a pessary if this isn't the default approach taken.

Such a minefield, but it's good to have MN as a resource for times like this. Best of luck and here's to us both going into labour spontaneously!

I was induced in Oxford (december 2008) and was given the gel first. Waters were broken about 4 hours later I think. The midwife told me they always give the gel first as research shows this leads to less complications.

Maybe their policy has changed in the last 15 months, but depending on the source of your information it might be worth giving delivery suite a ring and asking them. I'll probably be having another induction in about 6 weeks time, so would be interested to hear if their policy has changed.

Toffee, sending labour vibes your way!!

Greensnail, info direct from midwife. First labours they do gel first and second time (assuming they can) they break waters.

May all be academic now as have had a bleed this am and am currently sitting in jr for overnight monitoiring. They may induce early!!

but if you cannot be induced without gel, you have to have teh gel... just breaking waters might be enough if you are 3 - 4 cm dilated.. you might still need the synto drip too

i would think that if you cannot be given ARM then you will have the gel..

hope all goes well regardless of how it happens !

Hope all turns out ok roary. I was up there all morning today and narrowly avoided being admitted at the weekend too.

That's interesting about only doing gel first with first labours. I found it just made me really sore, so would be quite happy to go without this time!

Best of luck Roary

Was induced yesterday now have great big boy baby. Debate irrelevant as had to have a gel because cervix was so closed!!

But xan conclusively report that normal practice in Oxford is to brak waters for a second induction rather than start with gel!

Oh congratulations Roary, glad everything's worked out just fine!!

Congratulations roary! Glad everything worked out well for you and hope you're recovering and enjoying your baby boy. Thanks for the information about induction policy in oxford - really helps me know what to expect this time